ERCP联合ESWL治疗胰管结石12例报道

外科研究与新技术 ›› 2014, Vol. 3 ›› Issue (1): 17-21.

ERCP联合ESWL治疗胰管结石12例报道

张景涛¹, 桂亚平², 陈泉宁¹, 刘黎明¹, 范跃祖¹, 鲁星燧¹

1.同济大学附属同济医院外科上海 200065;
2.同济大学附属同济医院泌尿科上海 200065

出版日期:2014-03-28 发布日期:2014-01-25
通讯作者: 范跃祖(1958-),男,外科学教授,主任医师,博士生导师,E-mal:fanyuezuu@hotmail.com
作者简介:张景涛(1968-),男,外科学博士,主治医师,从事胆胰外科和ERCP诊疗。

Treatment of pancreatic duct stones with extracorporeal shock wave lithotripsy (ESWL) combined with endoscopic retrograde cholangiopancreatography (ERCP):a report of 12 cases

ZHANG Jing-tao¹, GUI Ya-ping2, CHEN Quan-ning¹, LIU Li-ming¹, FAN Yue-zu¹, LU Xing-sui¹

1.Department of Surgery,Tongji Hospital,Tongji University School of Medicine,Shanghai 200065,China;
2.Department of Urology,Tongji Hospital,Tongji University School of Medicine,Shanghai 200065,China

Online:2014-03-28 Published:2014-01-25

摘要/Abstract

摘要： 目的评价ERCP联合ESWL治疗胰管结石的效果。方法 2008年1月～2009年12月在我院经影像学确诊的12例胰管结石患者接受了ERCP联合ESWL治疗。先行ERCP以了解胰管形态改变并放置胰管支架;续行ESWL,依结石形态及密度了解碎石效果,对碎石不满意者重复ESWL;6～8周后再行ERCP取石。结果所有患者全部碎石成功(根据结石密度和体积变化);其中,1例行ESWL后结石完全排净,5例ESWL后经内镜治疗结石被完全清除,1例结石部分清除,1例取石失败,2例碎石后失访。治疗期间未出现严重并发症。结论 ESWL对胰管结石碎石效果好,但单纯ESWL仅部分患者结石可自行排出;ESWL后结合内镜取石治疗,能提高胰管结石清除效果。

关键词: 胰管结石, 体外冲击波碎石, 逆行胰胆管造影

Abstract: Objective To evaluate the efficacy of ESWL combined with ERCP for the treatment of pancreatic duct stones (PDSs).Methods 12 patients with PDSs confirmed by ultrasound and radiography received treatment in our hospital from January 2008 to March 2010.ERCP was first performed to determine the ductal morphology,the location and number of stones,which pancreatic sphincterotomy and stenting were performed depending on the condition of the patients.ESWL was performed in all patients and repeated depending on stone changes.6-8 weeks after ESWL,therapeutic ERCP for balloon dilation and stone extraction was performed to manage residual stones.Pancreatic stents were placed after stone extraction.Results ESWL was performed and stone fragmentation was achieved in all patients.Spontaneous stone clearance after ESWL alone occurred in one patient.Complete duct clearance was achieved in 7 patients by therapeutic ERCP; partial duct clearance was achieved in one patient; and duct clearance failed in one patients.Of the 12 patients,two patients failed to follow-up after ESWL.No procedure-related major complication occurred.Conclusions ESWL is effective for PDS fragmentation and can be repeated.A high rate of successful PDS clearance can be achieved when therapeutic ERCP is followed by ESWL

Key words: Pancreatic duct stone, Extracorporeal shock wave lithotripsy, Endoscopic retrograde cholangiopancreatography

中图分类号:

R657.5

张景涛, 桂亚平, 陈泉宁, 刘黎明, 范跃祖, 鲁星燧. ERCP联合ESWL治疗胰管结石12例报道[J]. 外科研究与新技术, 2014, 3(1): 17-21.

ZHANG Jing-tao, GUI Ya-ping2, CHEN Quan-ning, LIU Li-ming, FAN Yue-zu, LU Xing-sui. Treatment of pancreatic duct stones with extracorporeal shock wave lithotripsy (ESWL) combined with endoscopic retrograde cholangiopancreatography (ERCP):a report of 12 cases[J]. Surgical Research and New Technique, 2014, 3(1): 17-21.

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